Healthcare Provider Details

I. General information

NPI: 1215911789
Provider Name (Legal Business Name): JAMES R EVERETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 01/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 PERFORMANCE DR SUITE 110
WEYMOUTH MA
02189-3141
US

IV. Provider business mailing address

10 WILLARD ST
QUINCY MA
02169-1281
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-9091
  • Fax: 781-331-6355
Mailing address:
  • Phone: 617-479-1452
  • Fax: 617-479-3500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number33778
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: